Association of demographic characteristics, aggravating factors,
comorbidities and treatments with atopic dermatitis severity
Abstract
Background: Atopic dermatitis (AD) is one of the most prevalent
chronic inflammatory skin disorders that causes great disease burdens
world-wide. The demographics and clinical characteristics of AD are
different between countries, regions, and age groups yet these
differences were not well characterized in China. To get well guidance
for AD clinicians, we described the demographics, clinical
characteristics, comorbidities, patient-identified aggravating factors
and treatment of AD in all-age patients in China. Methods: This
study included Chinese individuals diagnosed with AD by accredited
clinicians in the department of dermatology of 205 hospitals from 31/34
provincial administrative divisions across China during August, 2021 to
September, 2022. All included patients completed dermatologist-lead
interviews regarding their general medical history, comorbidities,
AD-related aggravating factors and medications. Two-level mixed ordered
logistic regression was used to evaluate factors for aggravation of the
disease. Results: Overall, 16838 respondents were included in
the final analysis with a mean age of 30.94 years (standard deviation, ±
24.08 years). The proportion of patients with severe AD was the highest
in patients with onset of AD at ≥60 years old (26.73%). Allergic
rhinitis and hypertension were the most common atopic and non-atopic
comorbidities, respectively. AD severity was significantly associated
with chronic urticaria, food allergy and diabetes. There was a high
proportion of severe AD in patients who had aggravating factors such as
seafood, lamb and beef, chili peppers, alcohol, seasonal changes, and
psychological factors. Cross-sectional survey revealed unmet needs of
severe AD in treatment strategy, in lack of immunosuppressants’ and
biological agents’ application. Conclusion: Treatment of
comorbidities and control of aggravating factors significantly
contribute to AD management. Improving systemic immunotherapy could
reduce the incidence of severe AD.